Many of the Current Uninsured Won’t Gain Coverage, Study Suggests

Barring any major policy changes, most of the remaining non-elederly uninsured people in the U.S. likely won’t gain coverage, a new study released today suggests.

The study, from the Urban Institute and funded by the Robert Wood Johnson Foundation, says that while some higher-income people who are uninsured will surely gain coverage as the penalties for not having insurance increase, the possibility for increased coverage is actually lower among those who have higher incomes than those who are eligible for financial assistance to cover insurance.

Of those who are uninsured, 28 percent are eligible for Medicaid or the Children’s Health Insurance Program and 21 percent are eligible for marketplace tax credits, the study says.

Overall, 12.4 million people are eligible for the greatest amount of possible financial assistance under the Affordable Care Act, the study says. Increased efforts to reach those people are likely to be successful in helping them to gain health insurance and understanding the characteristics of that group is important, the study’s authors add.

“For example, within both the Medicaid/CHIP and marketplace populations of most interest, over 80 percent of the uninsured live in metropolitan statistical areas,” they write. “Nearly half of those uninsured eligible for Medicaid/CHIP have at least one school-aged child in the family; the same is true for 24 percent of the uninsured eligible for the most generous marketplace assistance.”

Where an uninsured person lives is also relevant, depending on whether they live in a state that has expanded Medicaid. While the split among uninsured people in states that have expanded Medicaid versus states that have not is roughly half, the uninsurance rate in states that have not expanded Medicaid is significantly higher in states that did not expand the program, the report says.

Clarification: The study’s figure of 12.4 million uninsured people who are eligible for financial assistance does not include those who are eligible for smaller tax credits. There are an additional 3.7 million people who qualify for small tax credits and little to no cost-sharing assistance.

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